Comparative Analysis of Total Body Irradiation (TBI)-Based and Non-TBI-Based Myeloablative Conditioning for Acute Myeloid Leukemia in Remission with and without Measurable Residual Disease

▪ Background:Myeloablative allogeneic hematopoietic cell transplantation (HCT) is a common post-remission treatment strategy for medically fit adults with acute myeloid leukemia (AML) in morphologic remission. Several conditioning regimens have been utilized for this purpose, with ongoing controversy regarding the benefit of high-dose total body irradiation (TBI) in this setting. It is also unknown whether the relative value of TBI- versus non-TBI-based myeloablative conditioning differs for patients presenting with measurable residual disease (MRD) at the time of HCT from those in MRDnegremission. These open questions prompted us to compare outcomes among a large cohort of adult AML patients in MRDposand MRDnegremission who had myeloablative allogeneic HCT at our institution. Patients and Methods:We retrospectively studied 387 consecutive adults ≥18 years with AML in first or second morphologic remission (i.e.